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Comment by PaulHoule | Hacker News Reader

The diagnostic words that start with "schizo-" are a train wreck.

Schizophrenia is characterized by hallucinations, delusions, thought disorder, catatonia, etc. You don't hear much about catatonia these days because it is cleared up by benzodiazepines reliably.

Schizoid people have reduced emotional reactions compared to other people but they are in touch with reality.

Schizoaffective disorder seems to pick a few symptoms from schizophrenia and bipolar but doesn't fit the criteria for either. You might think that sounds less severe but it can be devastating.

The romanticization of schizophrenia of r.d. Liang, "one flew over the cuckoo's nest", szasz and others strikes me as particularly cruel when I see how it keeps people who are suffering from getting help.

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I don't think "one flew over the cuckoo's nest" romanticizes mental illness, for me it is about demonizing institutionalization.

It pictures the time when mental illness diagnostic was an easy method to put away anyone annoying or inconvenient (the subject really having a mental illness or not made little difference). It talks about institutional cruelty like torture and lobotomy.

But then I didn't read the book, just watched the movie - perhaps the "romanticization of illness" angle is more pronounced in the book but I'm pretty sure it was not the main theme and the novel did more good than bad for those diagnosed with a mental disorder or developmental disability.

I mostly agree, but I think the movie romanticized the end of institutionalization, making us believe we've progressed "beyond" it, when we merely have people screaming on street corners and sleeping in the gutter. Institutionalization should've been reformed, not all but eliminated (I know it still exists, but only for the most extreme cases).

If someone is not a threat to themselves or others, but has strange beliefs and behaviors, should we really take their freedom away just because we don’t think they are taking care of themselves adequately or we don’t like the sight/sound of them?

As someone with bipolar disorder (very stable since diagnosis and medication) I’m always a bit dismayed when people call for locking ill people up “for their own good.” (Not that you’re necessarily saying that - it’s just something I do see people advocating for sometimes).

I’m in SF and previously lived Tenderloin-adjacent so I’m quite familiar with the unfortunate cycle of mental illness and drug/alcohol abuse from self-medicating. It’s not a pretty sight and I do think we should do everything we can to help these most vulnerable people in society. I’m just not sure taking their liberty is necessarily the best course of action.

This. I'm fortunate enough to be considered only "eccentric" as most people are willing to forgive my weirdness in exchange for other useful personality traits. Not everybody is that lucky.

I think that society probably has the right to enforce basic social norms so I think it is reasonable to for society to intervene if someone is being threatening or violating basic norms (e.g. by defecating in the middle of the sidewalk). Both of which are common in the Tenderloin.

The problem that I see is: what options are available other than violating their freedom by forcing them to undergo treatment or locking them up? You can't, for example, fine someone who doesn't have anything. Besides, I think its unlikely that punishment would accomplish anything

So I guess I'm not sure I see a good solution to the problem.

Well, the support network is far from perfect - having a 5yo son in the autistic spectrum I experience this first hand. Not too long ago my kid would be segregated to a "special" school and I'm glad he is able to attend a regular school although he still needs a dedicated tutor.

Do you think weird people that do not endanger their own life or the life of others should be locked away?

There’s a sizeable gap between “weird people” and defecating/shooting heroin on community sidewalks and public transit. I’m referring mostly to the latter.

We've absolutely progressed beyond lobotomies, caregivers raping or assaulting patients (...more so anyway), and in general lifelong imprisonment in sub human conditions. No were not all the way where we need to be but we're miles ahead of where we were.

> I don't think "one flew over the cuckoo's nest" romanticizes mental illness, for me it is about demonizing institutionalization.

Intent is one thing, effect is another. One Flew Over the Cuckoo's Nest, the book and movie, broke ground upon its release, but one of its secondary effects was to establish the mid-20th-century mental hospital as a gothic setting, akin to the ancient stone manors of old, full of terrible secrets -- not to mention bizarre characters -- that are ripe for literary exploration. Today it's been almost completely tropified, especially since in the current era Great Literature is by definition introspectively psychological. An easy way to establish that your play or movie is "arty" is to set it in such an institution. One of the weirdest instances of this was in The Great Gatsby (2013), which wholly took place in a mental hospital (the plot of the novel being Nick's recollections to his psychiatrist) and implied that Nick admired Gatsby almost to the point of a crush and was so devastated by his death as to need psychiatric attention.

I do recommend you read One Flew Over the Cuckoo's Nest, the novel. It is written from the perspective of Chief Bromden, and his mental illness helps intensify the themes of subtle control, exercised by tyrannical people and institutions, with specific delusions he has that make him sensitive to that control.

> It pictures the time when mental illness diagnostic was an easy method to put away anyone annoying or inconvenient

One of my friends was sent to Napa State Hospital by his step dad because he had epilepsy. When he was seven. It took six years for his dad to win custody, because his dad was a Mexican.

That was the world of One Flew Over the Cuckoo's Nest.

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